Facet joint syndrome is a condition of the tiny facet joints, which lie behind and between the vertebrae. Facet joints are responsible for the spine’s flexibility and stability. With facet syndrome, these joints become swollen and inflamed, which can lead to back or neck pain, headaches, and limited mobility.
The human spine has 24 irregular shaped bones called vertebrae. The facet joints connect these bones, with two facet joints between each pair of vertebrae (one on each side). The joints link each vertebra to those below and above it, and they allow the bones to rotate with respect to each other. Like other joints, facet joints have cartilage, which allows for smooth movement.
In a recent study, 500 patients with chronic spine pain were evaluated. Researchers evaluated for the prevalence of facet joint pain in accordance with the criteria established by the International Association for the Study of Pain. The researchers found that the prevalence of facet joint pain for patients with chronic neck pain was 55%, and for those with thoracic spine pain, the rate was 42%. In addition, 31% of the patients with lumbar spine pain had facet joint discomfort.
When the facet joints become irritated, inflamed, or swollen, they cause pain and impingement (pinching) of the nerves that supply the joints. Depending on the location of the facet joint irritation, associated symptoms can include pain radiating down an arm or leg, as well as leg/arm weakness, numbness, and tingling.
To determine if you have facet joint syndrome, the orthopedic surgeon will examine your back, evaluate muscle strength, and take a medical history. To assess for soft tissue and nerve problems, computed tomography and magnetic resonance imaging scans are used. A facet joint block can confirm the diagnosis. This involves injecting an anesthetic into or near the facet joint nerves. If there is pain relief, the doctor can assume facet joint syndrome exists.
Facet joint syndrome is often treated using a combination of non-surgical measures. These include:
When conservative measures fail to provide lasting pain relief, the orthopedic specialist may recommend spine surgery. Surgical options include:
Manchikanti L, Broswell MV, Singh V, et al. (2004). Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions. BMC Musculoskel Disord, 5, 15.